CT texture analysis as predictive factor in metastatic lung adenocarcinoma treated with tyrosine kinase inhibitors (TKIs)

Eur J Radiol. 2018 Dec:109:130-135. doi: 10.1016/j.ejrad.2018.10.016. Epub 2018 Oct 24.

Abstract

Purpose: To assess the predictive and prognostic value of pre-treatment CT texture features in lung adenocarcinoma treated with tyrosine kinase inhibitors (TKI).

Materials and methods: Texture analysis was performed using commercially available software (TexRAD Ltd, Cambridge, UK) on pre-treatment contrast-enhanced CT studies from 50 patients with metastatic lung adenocarcinoma treated by TKI. Texture features were quantified on a 5-mm-thick central slice of the primary tumor and were correlated with progression-free and overall survival (PFS and OS) using an internally cross-validated machine learning approach then validated on a bootstrapped sample.

Results: Median PFS and OS were 10.5 and 20.7 months, respectively. A noninvasive signature based on five texture parameters predicted 6-month progression with Area Under the Curve (AUC) of 0.8 (95% CI) and 1-year progression with AUC of 0.76. A high-risk group had hazard ratios for progression of 4.63 and 5.78 when divided by median and best cut-off points, respectively. Texture signature did not correlate with OS. Available clinical variables did not correlate with PFS or with OS.

Conclusion: Texture features seem to be associated with PFS in lung adenocarcinoma treated with TKI.

Keywords: Adenocarcinoma; Carcinoma; Epidermal growth factor; Non small cell lung; Prognosis; Progression-free survival; Protein kinase inhibitors; Receptor; Texture analysis; Tomography; X-ray computed.

MeSH terms

  • Adenocarcinoma of Lung / drug therapy*
  • Adenocarcinoma of Lung / mortality
  • Adenocarcinoma of Lung / pathology
  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Disease Progression
  • Disease-Free Survival
  • Erlotinib Hydrochloride / administration & dosage
  • Female
  • Gefitinib / administration & dosage
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Antineoplastic Agents
  • Erlotinib Hydrochloride
  • Protein-Tyrosine Kinases
  • Gefitinib